PDFWAC 182-514-0230

Purpose.

(1) This chapter describes eligibility requirements for the Washington apple health (WAH) modified adjusted gross income (MAGI)-based long-term care program (LTC) for children and adults who have been admitted to an institution as defined in WAC 182-500-0050 for at least thirty days. The rules are stated in the following sections:
(a) WAC 182-514-0240 General eligibility;
(b) WAC 182-514-0245 Resource eligibility;
(c) WAC 182-514-0250 Program for adults age nineteen and older;
(d) WAC 182-514-0260 Program for children under age nineteen;
(e) WAC 182-514-0263 Non-SSI-related institutional medically needy coverage for pregnant women and people age twenty and younger.
(f) WAC 182-514-0270 Involuntary commitment to Eastern or Western State Hospital.
(2) A noninstitutional WAH program recipient does not need to submit a new application for LTC coverage if admitted to an institution under this section. Admission to an institution constitutes a change of circumstances. Eligibility is based on institutional status under WAC 182-513-1320.
(3) In this chapter, "medicaid agency" or "agency" means the Washington state health care authority and includes the agency's designee. See chapter 182-500 WAC for additional definitions.
(4) Income standards used in this chapter are listed at http://www.hca.wa.gov/medicaid/eligibility/pages/standards.aspx.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 16-04-087, § 182-514-0230, filed 1/29/16, effective 2/29/16. Statutory Authority: RCW 41.05.021 and Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-06-068, § 182-514-0230, filed 2/28/14, effective 3/31/14. WSR 12-02-034, recodified as § 182-514-0230, filed 12/29/11, effective 1/1/12. Statutory Authority: RCW 74.04.055, 74.04.057, 74.08.090, 74.09.530, and 42 C.F.R. 441.151. WSR 09-06-029, § 388-505-0230, filed 2/24/09, effective 3/27/09.]